Managing acute pain in ICU

Todd Fraser on 27-11-2011

This week's podcast is with Dr Myles Conroy, head of the acute pain service at Geelong Hospital in Victoria. I must say I went into this interview thinking that I had a pretty tight grasp on the concept. Instead Myles shared his enormous experience with me, highlighting that this ubiquitous symptom remains a difficult one for us all to manage. In part one, out tomorrow, Myles covers the basics, and in part two next week, he'll expand on some more novel approaches, and how he would deal with some of the more tricky cases we see. Leave your comments on this podcast below.


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Alex McKenzie wrote 12-03-2011 12:08:15 pm
Interesting podcast - looking forward to part 2!

I did enjoy the discussion on NSAIDs. I can't seem to bring myself to prescribe them in ICU - I have old consultants' words ringing in my ears - never give NSAIDs to ICU patients!

Jo Butler wrote 12-04-2011 10:15:53 pm
Nice one - looking forward to episode 2

Would like to know a bit more about the agents you can squirt down an epidural - hopefully this is covered in the next one.

Todd Fraser wrote 12-12-2011 12:07:25 pm
I've just added a new paper on Buprenorphine on the Journal Club. This paper compared small doses of buprenorphine sublingually with morphine IV in patients with acute bone fractures. It compared favourably and had less side effects.

This seems interesting. I've seen it prescribed by anaesthetists before in situations where the enteral route is unavailable but IV medications are not desired.

Does anyone have experience with this?

Benjamin Moran wrote 12-13-2011 09:29:07 am
There is a slight prejudice against buprenorphine where I work. The main reason for this is the multitude of geriatric pts that are prescribed it for their arthritis pain (we must have good drug reps!), who fall and fracture their NOFs. Given it's a partial agonist, with a long half-life (72 hrs for a patch), it can make analgesing them difficult in the peri operative period.




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